Category: Nevin Manimala

Mult Scler Relat Disord. 2022 Feb 26;60:103712. doi: 10.1016/j.msard.2022.103712. Online ahead of print.

ABSTRACT

BACKGROUND: In the current COVID-19 pandemic, Multiple Sclerosis (MS) patients represent a population of particular interest as they might be at higher risk of COVID-19 infection and it’s complications. The present study aimed to investigate a one year follow up of patients with MS during the COVID-19 pandemic, in Qom province, Iran.

METHODS: This study was performed at the MS Clinic of Beheshti Hospital from June 1, 2020 to November 1, 2021. 202 patients with a diagnosis of MS and negative self-reported history of COVID-19 at the beginning of the pandemic, were enrolled. First, the demographic characteristics of patients were collected. Second, the patients underwent serological testing for anti-SARS-CoV-2 IgG antibodies. Then, a year later, they were revalauted and asked about the occurrence of clinical relapse leading to hospitalization, disease progression, DMT profile, COVID-19 vaccination, and history of COVID-19 infection. We considered six weeks after COVID-19 regarding relapse occurrence. Eventually, statistical analysis was carried out by using SPSS 26.0 RESULTS: Of 202 patients, 26 patients (12.87%) had initially a positive index antibody result. During the follow-up periods, 25 patients (12.37%) were infected with COVID-19 which was mainly mild (74.8%), and significantly lower than general population. 118 patients (58.41%) were vaccinated for COVID-19 which reduced the risk of COVID-19 development (P<001). Except a case of myelitis associated with vaccination, no serious adverse event was reported. Additionally, only one patient developed MS relapse following COVID-19 infection. Except clinical relapse (P = 0.001), other demographic and MS characteristics, and DMT type were not associated with COVID-19. In terms of MS course, 12 patients (5.94%) discontinued their DMTs regardless of the DMT adverse events or treatment failure. 41 patients (20.3%) experienced a clinical relapse, of whom 12 were escalated to a second line DMT. Further, 27 patients (13.4%) noted a history of worsening disability which mainly occurred after COIVD-19 infection.

CONCLUSION: The present study showed a significant lower incidence of COVID-19 infection in MS patients. Except for clinical relapse, other demographic and MS characteristics, and DMT type were not associated with COVID-19 infection. In addition, COVID-19 vaccination reduced the risk of COVID-19 development, and the prognosis was favorable in the majority of MS patients.

PMID:35247752 | DOI:10.1016/j.msard.2022.103712

Biochem Biophys Res Commun. 2022 Feb 25;602:35-40. doi: 10.1016/j.bbrc.2022.02.091. Online ahead of print.

ABSTRACT

OBJECTIVE: The aims of this study were to understand whether podocyte injury is involved in proteinuria after rapid ascent to high altitude and to explore whether hypoxia-inducible factor (HIF)-1α is involved in the adaptive regulation of this proteinuria.

METHODS: Rats in the experimental group were housed in a low-pressure oxygen chamber to simulate a high-altitude environment (5,000 m). The intervention group was placed under the same conditions as the experimental group and prolyl-hydroxylase inhibitor (PHI) was intraperitoneally injected. The control group was housed in a low altitude environment (500 m). On days 0, 7, 14, and 28, urinary albumin quantification and electrophoresis were performed. The expression levels of CD2-associated protein (CD2AP), nephrin and HIF-1α were detected by immunofluorescence.

RESULTS: The medium and large molecule proteins with molecular weights ranging from 63 to 75 kD were present in the urine of rats in the experimental group and that the urinary albumin levels first increased and then decreased with time and the increase on day 14 was most significant (24.58 ± 4.30 mg on day 14 VS 5.13 ± 1.58 mg on day 0). Electron microscopy revealed podocyte lesions in rats in the experimental group. Immunofluorescence results showed that the protein expression levels of CD2AP and nephrin in the glomeruli of rats in the experimental group were lower than those in the control group (P < 0.001) and that the expression levels of which in the intervention group were higher than those in the experimental group (P < 0.001). The expression of HIF-1α protein in the renal tissues of rats in the experimental group was higher than that in the control group (P < 0.001) and lower than that in the intervention group (P < 0.001).

CONCLUSION: The podocyte injury may be involved in the occurrence of proteinuria after rapid ascent to high altitude. PHI may have a potential role in reducing proteinuria by upregulating local HIF-1α expression in the kidney to alleviate podocyte injury.

PMID:35247702 | DOI:10.1016/j.bbrc.2022.02.091

J Chromatogr B Analyt Technol Biomed Life Sci. 2022 Feb 28;1195:123200. doi: 10.1016/j.jchromb.2022.123200. Online ahead of print.

ABSTRACT

Untargeted lipidomics using liquid chromatography high-resolution mass spectrometry (LC-HRMS) was performed using polarity switching, and in positive and negative polarity separately on the same set of serum samples, and the performances of the methods were evaluated. Polarity switching causes an increase in the cycle time of the HRMS measurements (1.18 s/cycle vs 0.27 s/cycle), resulting in fewer data points across chromatographic peaks. The coefficient of variation (CV) was on average lower for the added isotopically labelled standards in pooled samples (QC) and patient samples using separate polarities (QC = 5.6%, samples = 12.5%) compared to polarity switching (QC = 8.5%, samples = 13.4%), but the difference was not statistically significant. For the endogenous features measured in the QCs polarity switching resulted in on average significantly higher CVs (3.80 (p = 4.25e-30) and 3.3 percentage points (p = 6.84e-40), for positive and negative modes, respectively) however still acceptable for an untargeted method (mean CVs of 17.9% and 12.2% in positive and negative modes respectively). A slightly larger number of endogenous features were detected using the separate polarities, but the large majority of features (>95%) were detected with both methodologies. The overlap of features detected in both positive and negative polarities was low (4.1%) demonstrating the importance of using both polarities for untargeted lipidomics. When investigating the effects of a treatment on multiple sclerosis patients it was found that both methodologies gave highly similar biological results, further confirming the applicability of polarity switching.

PMID:35247679 | DOI:10.1016/j.jchromb.2022.123200

Ultrason Sonochem. 2022 Mar 1;84:105966. doi: 10.1016/j.ultsonch.2022.105966. Online ahead of print.

ABSTRACT

Ultrasound assisted aqueous two-phase extraction of polysaccharides from Cornus officinalis fruit was modeled by response surface methodology (RSM) and artificial neural network (ANN), and optimized using genetic algorithm coupled with ANN (GA-ANN). Statistical analysis showed that the models obtained by RSM and ANN could accurately predict the Cornus officinalis polysaccharides (COPs) yield. However, ANN prediction was more accurate than RSM. The optimum extraction parameters to achieve the highest COPs yield (7.85 ± 0.09)% was obtained at the ultrasound power of 350 W, extraction temperature of 51 ℃, liquid-to-solid ratio of 17 mL/g, and extraction time of 38 min. Subsequently, the crude COPs were further purified via DEAE-52 and Sephadex G-100 chromatography to obtain a homogenous fraction (COPs-4-SG, 33.64 kDa) that contained galacturonic acid, arabinose, mannose, glucose, and galactose in a molar ratio of 34.82:14.19:6.75:13.48:12.26. The structure of COPs-4-SG was also characterized with UV-vis, fourier-transform infrared spectroscopy (FT-IR), atomic force microscopy (AFM), scanning electron microscopy (SEM), Congo-red test, and circular dichroism (CD). The findings provide a feasible way for the extraction, purification, and optimization of polysaccharides from plant resources.

PMID:35247682 | DOI:10.1016/j.ultsonch.2022.105966

Vision Res. 2022 Mar 2;196:108028. doi: 10.1016/j.visres.2022.108028. Online ahead of print.

ABSTRACT

In conventional psychophysical reverse correlation methods using white or pink noise, the luminance noise is added to every pixel. Thus, the image features correlated with perception are often biased toward local mean luminance. Furthermore, spatial frequencies and orientations are represented in the primary visual cortex, which forms the basis of various visual perception. In this study, we proposed a new reverse correlation method using noise that modulated the spatial frequency sub-band contrast and examined its properties in psychophysical experiments on facial skin lightness perception. In the experiment, we asked the observers to compare the perceived skin lightness in a paired comparison manner on face stimuli with increased or decreased spatial frequency sub-band contrasts at random spatial locations. The results showed that the contrasts in the eyes or irises were strongly and positively correlated with the perceived skin lightness in most sub-bands, demonstrating that the proposed method reiterated the findings of previous studies that the sparkle of the irises makes the skin appear lighter. Contrarily, the conventional reverse correlation method using pink noise images was applied to the skin lightness perception. The results indicated that only the local mean luminance in some skin regions, such as the forehead, was correlated with skin lightness perception. In summary, with the proposed method, we found some image features in the facial parts other than the skin mean luminance relevant to skin lightness perception, which are difficult to detect using the conventional method. They are considered complementary given that the proposed method and the conventional method extracted considerably different image features. It depends on the psychophysical tasks and stimuli which one is more appropriate.

PMID:35247671 | DOI:10.1016/j.visres.2022.108028

J Allergy Clin Immunol Pract. 2022 Mar 2:S2213-2198(22)00219-7. doi: 10.1016/j.jaip.2022.02.018. Online ahead of print.

ABSTRACT

BACKGROUND: Skin diseases associated with blood or tissue eosinophilia are common. As their clinical manifestations are various, making the correct diagnosis can be challenging. So far, dermatological patients with concomitant blood eosinophilia have not been characterized.

OBJECTIVE: We aimed at investigating patterns of dermatological patients with concomitant blood eosinophilia in order to obtain information helpful for optimizing disease management.

METHODS: In this retrospective study, demographic and clinical data and diagnostic test results of all patients presenting with dermatoses associated with blood eosinophilia (DABE) referred to a university center from 2014 to 2018 were extracted from the electronic patient charts and evaluated using descriptive and semantic map analyses.

RESULTS: A total of 453 patients (51.4% females; mean age 58.4 ±21.7 years) were included and grouped according to blood absolute eosinophil counts: severe, ≥1.5 G/L (n=87; 19.2%), moderate, 1.0 – 1.49 G/L (n=73; 16.1%), and mild eosinophilia, 0.5 – 0.99 G/L (n=293; 64.7%). Most patients presented with chronic (64.6%), generalized skin lesions (75.9%), and pruritus (88.1%). Statistical analyses revealed three distinct patterns: 1. mild eosinophilia associated with localized skin disease, age <50 years, history of atopy, diagnosis of eczema or infectious disease, 2. moderate eosinophilia linked to generalized skin lesions, pruritus, age > 70 years, and autoimmune bullous disease, and 3. severe eosinophilia associated with diagnosis of hypereosinophilic syndromes, drug hypersensitivity or malignant disesase.

CONCLUSIONS: Based on the pattern analysis of patients with DABE, a diagnostic workup has been developed aiming at setting the correct differential diagnosis in a feasible and effective manner.

PMID:35247633 | DOI:10.1016/j.jaip.2022.02.018

Anaesth Crit Care Pain Med. 2022 Mar 2:101053. doi: 10.1016/j.accpm.2022.101053. Online ahead of print.

NO ABSTRACT

PMID:35247639 | DOI:10.1016/j.accpm.2022.101053

World Neurosurg. 2022 Mar 2:S1878-8750(22)00260-1. doi: 10.1016/j.wneu.2022.02.113. Online ahead of print.

ABSTRACT

OBJECTIVE: The National Inpatient Sample – the largest all-payer inpatient database in the United States – is an important instrument for big data analysis of neurosurgical inquiries. However, earlier research has determined that many NIS studies are limited by common methodological pitfalls. In this study, we provide the first primer of NIS methodological procedures in the setting of neurosurgical research and review all published neurosurgical studies utilizing the NIS.

METHODS: We designed a protocol for neurosurgical big data research using the NIS, based on the authors’ subject matter expertise, NIS documentation, and input and verification from the Healthcare Cost and Utilization Project. We subsequently used a comprehensive search strategy to identify all neurosurgical studies utilizing the NIS in the PubMed and MEDLINE, Embase, and Web of Science databases from inception to August 2021. Studies underwent qualitative categorization (years of the NIS studied, neurosurgical subspecialty, age group, and thematic focus of study objective) and analysis of longitudinal trends.

RESULTS: We identified a canonical, four-step protocol for NIS analysis: study population selection, defining additional clinical variables, identification and coding of outcomes, and statistical analysis. Methodological nuances discussed include identifying neurosurgery-specific admissions, addressing missing data, calculating additional severity and hospital-specific metrics, coding perioperative complications, and applying survey weights to make nationwide estimates. Inherent database limitations and common pitfalls of NIS studies discussed include lack of disease process-specific variables and data following the index admission, inability to calculate certain hospital-specific variables after 2011, performing state-level analyses, conflating hospitalization charges and costs, and not following proper statistical methodology for performing survey-weighted regression. In a systematic review, we identified 647 neurosurgical studies utilizing the NIS. While almost 60% of studies were published after 2015, <10% of studies analyzed NIS data after 2015. The average sample size of studies was 507,352 patients (standard deviation=2,739,900). Most studies analyzed cranial procedures (58.1%) and adults (68.1%). The most prevalent topic areas analyzed were surgical outcome trends (35.7%) and health policy and economics (17.8%), while patient disparities (9.4%) and surgeon or hospital volume (6.6%) were the least studied.

CONCLUSIONS: We present a standardized methodology to analyze the NIS, systematically review the state of the NIS neurosurgical literature, suggest potential future directions for neurosurgical big data inquiries, and outline recommendations to improve the design of future neurosurgical data instruments.

PMID:35247618 | DOI:10.1016/j.wneu.2022.02.113

World Neurosurg. 2022 Mar 2:S1878-8750(22)00265-0. doi: 10.1016/j.wneu.2022.02.118. Online ahead of print.

ABSTRACT

OBJECTIVE: Preoperative embolization for intracranial meningiomas can cause tumor necrosis, reduce intraoperative blood loss, and facilitate surgery. This study aimed to evaluate the efficacy of tumor embolization using Embosphere® microspheres for skull base meningiomas and analyze post-embolization plain computed tomography (CT) and magnetic resonance imaging (MRI) scans to identify findings that could potentially predict treatment response.

METHODS: Between April 2014 and April 2020, 80 patients with skull base meningiomas presenting at our medical center underwent embolization with Embosphere® microspheres. The effects of tumor embolization were evaluated through a comparison of post-embolization plain CT and contrast-enhanced MRI.

RESULTS: A total of 143 vessels (102/108 external carotid artery branches; 41/65 internal carotid artery branches) from 80 skull base meningiomas were embolized with Embosphere® microspheres. Microspheres 100-300 μm in size were used in two cases, microspheres 300-500 μm in size were used in 12 cases, and microspheres 500-700 μm in size were used in 66 cases. Post-embolization contrast-enhanced MRI showed reductions in enhancing lesions within the tumor in 55/80 cases. Post-embolization plain CT scans showed high-density lesions within the tumor in 41/55 cases. Thus, reductions in enhancing lesions on post-embolization contrast-enhanced MRI were statistically significantly associated with the presence of high-density lesions on post-embolization plain CT (P<0.001). Embolization-related neurological complications occurred in three cases.

CONCLUSIONS: Embosphere® microspheres are user friendly and effective embolic materials for the embolization of skull base meningiomas. Post-embolization contrast-enhanced MRI and plain CT findings may be useful for evaluating the effects of tumor embolization.

PMID:35247619 | DOI:10.1016/j.wneu.2022.02.118

Acta Chir Orthop Traumatol Cech. 2022;89(1):68-74.

ABSTRACT

PURPOSE OF THE STUDY Exploring the therapeutic potential of pathological fractures treatment of the proximal femur in childhood with LCP paediatric hip plate system according to the principles of AO. MATERIAL AND METHODS Six children with pathological fractures of the proximal femur and with an unicameral bone cyst have undergone surgery in our institution, in the period between June 2018 up until December 2020. All patients were young boys with a mean age of 11.83 ± 3.43 years. According to the classification of Delbet-Colonna, three of the fractures were Type IV – intertrochanteric fractures and three were Type III – basocervical fractures. ccording to the AO Trauma classification, one of the fractures was complete transtrochanteric multifragmentary (31-M/3.2.III), two were complete transtrochanteric simple (31-M/3.1.III), one was Complete basocervical multifragmentary (31-M/3.2.II) and two were complete basicervical simple (31-M/3.1.II). All patients have undergone open reposition and osteosynthesis with a 130° LCP pediatric hip plate system (DePuy Synthes Pediatric LCP Plate System). In four of the patients, one or two of the proximal locking screws pass through the growth plate, to ensure more stability. The anatomical correction of the proximal femur has been measured through the cervico-diaphyseal angle, consolidation of the fracture, the spontaneous reparation of the cyst according to the Capanna classification and cystic index, presence of avascular necrosis of the epiphysis, shortening of the extremity, and functional grading by the Musculoskeletal Tumor Society (MSTS) staging system. The Mann-Whitney (Wilcoxon W) test was used for data processing. RESULTS The mean timing of the follow-up after the surgery was 22 months (range 6-32). A radiographically supported consolidation of the fracture has occurred at an average timing of 4.8 months (range 3-6) in all patients. There is no clinical or radiological evidence of postoperative avascular necrosis in any of the patients. According to the classification of Capanna, in five of the six patients a spontaneous reparation of the cyst has occurred. In one of the cases, the reparation is classified as grade II with a pathological cystic index of 2.27. A postoperative correction of the varus fracture deformity of the proximal femur has been achieved in all children. The cervical-diaphysary angle of 112.50° preoperatively has been corrected to 137.17° (p=0.002). The achieved correction is lasting and the average value of the CDS at the final follow-up is 138.17° (p=0.794). Intraoperative correction, statistically equal to the CDA of the healthy side (p=0.942) is achieved with this operative technique. Data from the MSTS show functional correction on the third postoperative month with 38.33% of the norm (p=0.002) and 85% on the final follow-up (p=0.002). A contralateral distal femoral surgical epiphysiodesis by the method of Métaizeau has been used for the correction of the difference in the length of the extremities (with an average of 2.9 cm). CONCLUSIONS Osteosynthesis with an LCP paediatric hip plate system gives the opportunity for anatomical correction of the proximal femur with a low risk of avascular necrosis and achieving optimal functional results in pathological basocervical and intertrochanteric fractures in childhood. The use of 5mm plates and penetration of the proximal screw through the growth plate holds an increased risk of growth disruption. Key words: LCP paediatric hip plate system, pathological fracture, unicameral bone cysts, proximal femur.

PMID:35247247